[...]... term hemangioma make interpretation of older studies difficult The incidence of IH has been estimated to be 1% to 5%.1 Risk factors for development of IH include Caucasian ethnicity, low birth weight, and female sex (female to male ratio of 2.4:1).2,3 Infants who are products of a multiple gestation pregnancy have a higher risk of developing a hemangioma The incidence of multiple gestation in a large... (intraspinal hemangioma or lipoma, structural malformation of the cord, or tethered cord).29 Of these, 35% had an isolated IH without other signs of spinal dysraphism This corresponded to a relative risk of spinal anomalies of 640 (children with IH plus another cutaneous sign of spinal dysraphism) and 438 (children with isolated IH) Given the low sensitivity of ultrasound (50%) demonstrated in the aforementioned... Rubenstein MC, Levy ML, et al Response of ulcerated perineal hemangiomas of infancy to becaplermin gel, a recombinant human platelet-derived growth factor Arch Dermatol 2004;140(7):867–70 35 Enjolras O, Riche MC, Merland JJ, et al Management of alarming hemangiomas in infancy: a review of 25 cases Pediatrics 1990;85(4):491–8 36 Barrio VR, Drolet BA Treatment of hemangiomas of infancy Dermatol Ther 2005; 18(2):151–9... locally invasive Skin over the tumors was most often described as deep red to purple in color with an advancing ecchymotic rim The tumors were often warm and leathery to palpation4 with a nodular feel Widespread cutaneous petechiae were often seen in subjects a Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplant, Medical College of Wisconsin, 8701 Watertown Plank Road, MFRC... doi:10.1016/j.pcl.2010.08.003 pediatric. theclinics.com 0031-3955/10/$ – see front matter Ó 2010 Elsevier Inc All rights reserved 1092 Huang & Liang adopted by clinicians and is the accepted classification of the International Society for the Study of Vascular Anomalies(ISSVA) (Table 1) Although there are several types of vascular tumors, hemangiomas represent the overwhelming number of vascular tumors encountered by pediatricians... considered to be birthmarks, they are often not recognized until a few weeks of age Unlike traditional birthmarks whose appearance remains relatively stable throughout life, IH demonstrate change over the first months of life Early on, they can appear as a telangiectatic patch or an area of pallor (Fig 1) Historically, IHs have been classified by their depth of soft tissue involvement (superficial,... assessing the exact incidence of IHs Incidence has been difficult to ascertain, because IHs may not appear until after the immediate newborn period In addition, the confusing nomenclature and often a Department of Dermatology, Children’s Hospital of Wisconsin, Medical College of Wisconsin, Suite B260, 9000 West Wisconsin Avenue, Milwaukee, WI 53226, USA b Children’s Hospital of Wisconsin, 9000 West Wisconsin... limited by the depth of their penetration compared with the depth of hemangioma involvement Doses of intralesional triamcinolone should not exceed 3 to 5 mg/kg per treatment.36 Repeated injections are often necessary to maintain response Central retinal artery occlusion, believed to be the result of pressure exceeding systolic pressure during injection, has been reported in the treatment of periocular hemangiomas,... arrest, and even regression of IHs have been observed with administration of propranolol.42,43 Since the initial report, the use of propranolol for IH has soared, as it is perceived to have a lower adverse effect profile than other systemic therapies used for treating IH Its mechanism of action in the treatment of IH is unknown Doses of 1 to 3 mg/kg/d divided twice or three times daily are typically used,... Its use in the treatment of proliferating IH remains controversial, as adverse outcomes including ulceration and scarring have been described.45 In addition, the use of PDL for intact IH is limited by the depth of the laser’s penetration (1 mm) There are a number of reports and two prospective studies describing its benefit in the treatment of ulcerated hemangiomas both in terms of speeding re-epithelialization . Professor of Pediatrics and Dermatology, University of Pennsylvania School of Medicine; Attending Physician, Section of Pediatric Dermatology, Division of. fee of $223.00. Contributors GUEST EDITORS BETH A. DROLET, MD Professor and Vice Chairman of Dermatology; Professor of Pediatrics, Medical College of Wisconsin;